Feline Dementia: Signs of Cognitive Dysfunction in Cats, and How to Help

Feline dementia, known to vets as cognitive dysfunction, is the cat version of the aging brain: a slow decline in memory, awareness, and behavior as an older cat's neurons wear out. It is common, and it climbs steeply with age, so it helps to know where your cat sits on the aging curve. Its onset is gradual, which sets it apart from a sudden loss of balance and head tilt, a different problem entirely. There is no cure, but a good deal of what helps is ordinary care you can arrange at home. If your older cat seems lost in familiar rooms, wakes and calls out at night, or has started forgetting the litter box, this is often the name for it, though your vet will want to rule out a few treatable look-alikes first.

This describes what cognitive dysfunction looks like and how it is managed, with the medical terms defined in the senior cat health glossary. Whether it is what your cat has is a question for your vet, and an important one, because several treatable diseases can wear the same disguise.

What cognitive dysfunction is

PetMD describes dementia, or cognitive dysfunction, as a condition seen in some senior cats that affects their memory, critical thinking, behavior, and reason, caused by the age-related degeneration of the brain and subsequent death of neurons. Cornell's Feline Health Center puts it in terms most of us will recognize, calling it a puzzling, progressively debilitating condition whose signs resemble those associated in humans with Alzheimer's disease and senile dementia. It arrives quietly, one small oddity at a time.

The signs and symptoms of cognitive decline

The changes owners notice most are disorientation, a flipped sleep cycle, and a cat who is somehow not quite herself. PetMD lists acting disoriented or lost, being awake and active in the middle of the night and vocalizing, often at night, unusual interactions with other pets or family members, which for some cats means growing suddenly clingy, Going to the bathroom outside the litterbox, and sleeping more than usual by day.

The night-time part is often what finally brings people to the vet, exhausted. There is more on that specific sign, and its other possible causes, in why a senior cat cries at night.

How common it is

Common, and it rises steeply with age. PetMD notes that more than a quarter of cats aged 11 to 14 show at least one sign of dementia, rising to half of cats over the age of 15. If you have a cat in her teens, in other words, some of this is close to expected, which is worth holding onto before you blame yourself for not noticing sooner.

Why it is diagnosed last, not first

Getting this one right turns on a single idea: cognitive dysfunction is a diagnosis of exclusion. Cornell's Feline Health Center puts the sequence plainly: After other potentially causative conditions, such as hyperthyroidism and kidney disease, are ruled out, a vet can treat what is left. PetMD makes the same point, that vets rely on ruling out other conditions first. These are conditions that can all mimic its signs. A cat wandering and calling out at night could have an overactive thyroid, high blood pressure, the quiet nausea of chronic kidney disease, or sore joints keeping her awake, and every one of those is treatable. So a real diagnosis of dementia usually means the fixable causes have already been checked and dealt with. Bloodwork and a blood pressure reading come before the label.

What helps

There is no cure, but PetMD is clear that you can do several things to manage dementia and minimize stress in your cat's life. The management runs on a few tracks at once.

• Keep her world predictable and easy to navigate. PetMD suggests making sure she has access to food, water, and a litter box. A confused cat who has started sleeping in the box itself is often doing it because the box is the one landmark she can still find. PetMD also notes, and notes that A night light or a radio playing soft music may help your cat with anxiety caused by disrupted sleep patterns. It also helps to keep to a steady routine with fewer big changes.
• Keep her mind working. Gentle daily play, treat puzzles, treat balls, and other interactive games help keep an aging brain engaged.
• Ask about diet and supplements. PetMD says SAMe, an antioxidant, may be helpful, and that CoQ10, omega fatty acids, and Vitamin E may also be recommended, along with veterinary diets aimed at the aging brain.
• Medication, when it is needed. Vets sometimes prescribe selegiline and propentofylline for cognitive dysfunction, or gabapentin for the anxiety and night restlessness.

Punishing the accidents or the small-hours confusion only frightens a cat who is already lost. What she needs from you is steadiness, and that steadiness is genuinely part of her treatment.

When to see the vet

Book a visit for any new disorientation, night-waking, or litter-box lapse in an older cat. Going serves two purposes: to rule out the treatable diseases that imitate dementia, and, if it does turn out to be dementia, to start the management early, while it does the most good.

There is a particular grief in a cat who seems to forget the shape of her own home, or who looks at you at three in the morning as though she is not quite sure who you are. It is one of the harder things about loving an old animal. What steadies me is that it is common, that it is nobody's fault, and that a cat this far into her life still knows the things that matter most: a warm lap, a quiet room, and the person who keeps showing up. You cannot give her back the years. You can make the ones she has left gentle, and that turns out to be nearly everything. That is the quiet mercy of cognitive dysfunction in cats: it dims the map she carries of her home, not the bond she has with the person in it.

Frequently asked questions

How do I tell if my cat has dementia? You cannot be certain at home, because the look-alikes are real, but Cornell's list is the one to hold your cat against. The signs include spatial disorientation; wandering away from home into unfamiliar territory; lack of interest in playing; excessive sleeping; altered cycles of sleep and wakefulness, along with staring at walls, indifference to food and water, and litter-box lapses. Two or three of those, arriving gradually in a cat past ten, is the pattern; one of them arriving suddenly is more often something else, and either way the next step is the vet, who rules out the treatable causes first.

At what age do the symptoms of cognitive decline in cats show up? Late, and slowly. Cornell notes that the behavioral signs of cognitive dysfunction tend to become clearly noticeable in cats that are 10 years of age or older, and the prevalence figures climb steeply through the teens. The symptoms creep in over months, which is exactly why they get filed under "just old" for a long time before anyone names them.

Sources

• Cornell Feline Health Center, Cognitive Dysfunction
• PetMD, Dementia in Cats